Stirling County Youth Academy

1
PICK YOUR CAMP/SPLEASE CHOOSE ALL THAT APPLY
Easter Camp (Mixed) 6th - 10th April 2026
July Summer Camp (Mixed) 13th-17th July 2026
July Summer Camp Girls 20th-23rd July 2026
August Summer Camp (Mixed) 3rd - 7th August 2026
2
Parent / Guardian Full Name* This field is required.
Mr.
Mr.
Ms.
Mrs.
Prefix
First Name
Last Name
3
Parent / Guardian Contact Phone Number* This field is required.
Area Code
Phone Number
4
Parent / Guardian Email* This field is required.
example@example.com
Confirm Email
5
Would you like to be added to the Stirling County Youth Academy mailing list?* This field is required.
YESNO
6
Player Name* This field is required.
First Name
Last Name
7
Player Date of Birth* This field is required.
Date
Day
Month
Year
8
Player Address* This field is required.
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
Is Your Player Currently a Member of Stirling County Rugby Club?* This field is required.
Please Select
Please Select
Yes
No, but I'd like more information
No, not at this point
Please Select
10
Or, Does Your Player Currently Play for Another Club?
Please Select
Please Select
Yes
No
Or, Does Your Player Currently Play for Another Club?
If yes, which
11
Does your player have any medical conditions we need to be aware of? Please include allergies and intolerances* This field is required.Medical Conditions, including Food Intolerances
Please Select
Please Select
Yes
No
Medical Conditions
Medical Condition Details
12
Does your player need to carry medication with them?* This field is required.Medication Carrier
Please Select
Please Select
Yes
No
Does your player carry medication?
More detail
13
PRIMARY EMERGENCY CONTACT* This field is required.
NAME
RELATIONSHIP
TELEPHONE
14
SECONDARY EMERGENCY CONTACT
NAME
RELATIONSHIP
TELEPHONE
15
In the event of serious accident or injury to your child every effort will be made to contact you. Where this proves impossible, do you consent to your child receiving any medical/surgical/dental treatment including a general anaesthetic and/or blood transfusion, as considered necessary by the Medical Authorities present?
YESNO
16
Do you consent to photographs of your child being used on the Stirling County website, or public social media channels?* This field is required.
YESNO
17
Please sign your consent to these questions* This field is required.By signing and submitting this form, I agree to my son/daughter/child in my care taking part in the activities of the club

STIRLING COUNTY YOUTH CAMPS 2025

My Bag

19
ADMIN ONLY
Should be Empty:

	Quantity		Price
Non County Member	1
County Member	1
Full Week 2nd Child Discount	1
Monday 6th	1
Tuesday 7th	1
Wednesday 8th	1
Thursday 9th	1
Friday 10th	1
Funded Place Request	1

	Quantity		Price
Non County Member	1
County Member	1
Full Week 2nd Child Discount	1
Monday 13th	1
Tuesday 14th	1
Wednesday 15th	1
Thursday 16th	1
Friday 17th	1
Funded Place Request	1

	Quantity		Price
Non County Member	1 2 3 4 5 6 7 8 9 10
County Member	1 2 3 4 5 6 7 8 9 10
Monday 20th	1 2 3 4 5 6 7 8 9 10
Tuesday 21st	1 2 3 4 5 6 7 8 9 10
Wednesday 22md	1 2 3 4 5 6 7 8 9 10

	Quantity		Price
Non County Member	1
County Member	1
Full Week 2nd Child Discount	1
Monday 3rd Aug	1
Tuesday 4th Aug	1
Wednesday 5th Aug	1
Thursday 6th Aug	1
Friday 7th Aug	1
Funded Place Request	1